Alkylating Agents

Drug Name	Severity of Reaction	Mucosal Effects and Notes
Busulfan	Mild	Mucosal effects rare
Caroplatin	Moderate	Emetogenic, but little mucocutaneous effect
Carmustine	Severe to Very Severe	Nausea and vomiting persist for 4-6 hours; few mucosal effects
Chlorambucil	Rare	Infrequent nausea, vomiting, diarrhea, or oral ulceration
Cisplatin	Severe to Very Severe	Highly emetogenic, persisting up to 1 week; mucosal
Cyclophosphamide	Rare to Severe	Nausea/vomiting increase with dose; stomatitis/mucositis may occur
Dacarbazine	Severe to Very Severe	Highly emetogenic, duration 2-4 hours; rare mucosal effects
Ifosfamide	Moderate to Severe	Significant nausea and vomiting, up to 3 days; limited mucosal effects
Lomustine	Severe to Very Severe	Nausea and vomiting common, stomatitis and diarrhea in 1% to 10%
Mecholarethamine	Very Severe	Highly emetogenic, duration 2-8 hours, diarrhea in 1% to 10%
Melphalan	Rare to Very Severe	Emetogenic only at high doses; infrequent stomatitis and diarrhea
Procarbazine	Severe	Significant nausea/vomiting; infrequent stomatitis (1% to 2%)
Streptozocin	Very Severe	Highly emetogenic (duration 1-12 hours)
Thiotepa	Mild to Very Severe	Mucositis frequent at doses used in bone marrow transplant (BMT)

Antineoplastic Antibiotics

Drug Name	Severity of Reaction	Mucosal Effects and Notes
Bleomycin	Mild	High mucosal toxicity
Dactinomycin	Very Severe	Highly emetogenic (lasting 4-24 hours); high mucocutaneous toxicity
Daunorubicin	Moderate	High mucosal toxicity
Doxorubicin	Moderate to Severe	High mucosal toxicity
Idarubicin	Moderate	High mucosal toxicity; GI hemorrhage up to 30%
Mitomycin	Moderate	High mucosal toxicity
Mitoxantrone	Moderate	Severe diarrhea and mucosal toxicity
Pentostatin	Mild	Diarrhea >10%; stomatitis approximately 5%
Plicamycin	Mild	Moderate to high incidence of stomatitis (1% to 10%)

Antimetabolites

Drug Name	Severity of Reaction	Mucosal Effects and Notes
Cladribine	Rare	Low nausea/vomiting and little mucosal effect
Cytarabine	Mild to Severe	High mucosal toxicity
Floxuridine	Rare	High mucosal toxicity
Fludarabine	Rare	Mild nausea/vomiting; stomatitis and GI bleeding may occur
Flurouracil	Mild to Moderate	Anorexia and stomatitis; mucocutaneous toxicity may be severe
Gemcitabine	Rare	Stomatitis 10% to 14%
Hydroxyurea	Mild	Anorexia and stomatis may be severe
Mercaptopurine	Rare	Moderate to high stomatitis 1% to 10% pancreatitis
Methotrexate	Mild to Severe	High incidence of mucosal damage, also pancreatitis
Thioguanine	Rare	High mucosal toxicity

Natural Course (Plant) Derivatives

Drug Name	Severity of Reaction	Mucosal Effects and Notes
Docetaxel	Rare	High mucosal toxicity; diarrhea in approximately 25%
Etoposide	Mild	Some mucosal 1% to 6%; diarrhea in 1% to 13%
Irinotecan	Moderate	Very high incidence of diarrhea
Paclitaxel	Rare	High mucositis incidence, severe at higher doses
Teniposide	Moderate	High mucositis incidence, diarrhea up to 75%
Topotecan	Mild	Nausea in up to 70%, emesis <30%, diarrhea in up to 42%
Vinblastine	Rare	Stomatitis and diarrhea are common
Vincristine	Rare	High mucosal toxicity, common constipation and adynamic ileus
Vinorelbine	Rare	High mucositis >44%, constipation 35%

Miscellaneous

Drug Name	Severity of Reaction	Mucosal Effects and Notes
Asparaginase	Rare	May cause pancreatic/malabsoprtion but little direct mucotoxicity
Mitotane	Severe	May cause severe nausea, vomiting, diarrhea (occurs in ~20%)

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